219637 05/07/2013 „*f CITY OF CARMEL, INDIANA VENDOR: 366932 Page 1 of 1
ONE CIVIC SQUARE ACTIVE911,INC
CARMEL, INDIANA 46032 CHECK AMOUNT: $94.03
5216 N 19TH STREET
s� PHILOMATH OR 97370 CHECK NUMBER: 219637
CHECK DATE: 5/712013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4355200 798 94 . 03 SUBSCRIPTIONS
Date: April 19, 2013
Invoice # [798]
NVOIIL'�-- --iL-'
Active911, Inc. TO: Carmel Fire Department- II
521b N. 19"St ALL
Philomath,Oregon Adam Harrington
97370 2 Civic Square
541-223-7992 Carmel,IN 46032.
contact@active911.com Customer ID 2099
SHIPPING SHIPPING DELIVERY PAYMENT
SALESPERSON JOB METHOD TERMS DATE TERMS TDUE DATE
R.Sullivan i Due on Receipt
QUANTITY ITEM# DESCRIPTION i UNIT PRICE DISCOUNT LINE TOTAL--
Agency Device $ 110.00
10 AD Subscription $11.00
10 --_D Prorate Discount $1.60 $ 15.97
-.
t
T-
Total Discount
L
S u b t o t a l $ 94.03
Sales Tax
T o t a l i $ 94.03
L
Make all checks payable to Active911, Inc.
THANK YOU FOR YOUR BUSINESS!
Drescribed by State Board of Accounts City Form No.201(Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
4n invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
798 Addt'I Subscriptions $94.03
1 hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Active 911, Inc.
IN SUM OF $
521 B N 19th Street
Philomath, OR 97370
$94.03
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1120 I 798 I 43-552.00 I $94.03 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Y
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund